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SubQ Injections Research / Studies to Show a Reluctant Doctor

SubQ Testosterone Injection Studies

One question that I get from time to time on the Peak Testosterone Forum is “do you have any subq (subcutaneous) studies that I can show my physician to prove that this is a legitimate protocol?” And the answer is ‘yes,’ although there is not as much out there as one might hope for. This is a topic that is near and dear to my heart, because it took me over a year to find a doctor that a) knew about subQ and b) was willing to let me use it.

In my case, I stumbled upon a doctor – my primary care in this case – who did not need a lot of persuading:  she felt comfortable with it just from a common sense standpoint. And you may find that this is the case with your doctor as well, because many physicians are comfortable with subQ injections since their diabetic patients utilize them on a daily basis with a hormone (insulin).

Why did I want to go on subQ injections?  The primary answer is that it easily allows a man to inject 2 or more times per week, which allows for a much more physiological HRT (TRT).  Weekly cypionate injections tend to give you a fairly big spike in the first day to three days.  SubQ is rumored to lead to lower estradiol levels and I found that to be the case.  It was one of the things that helped me get my estradiol levels down.  For details, see my page on SubQ Cypionate, the Best HRT Protocol?

SubQ is also incredibly convenient.  The shots are almost painless, easy to give yourself and there is no need for aspiration.  In addition, if you are going to self-administer an intramuscular shot, it is usually in the quad and this sometimes can be uncomfortable and requires a little larger needle than subcutaneous.

However, for those of you who do not have any such good fortune, here is some research-backed evidence that you can show your physician:

1. Antares Quick Shot.  There is currently a patent on a subQ “pen” that actually capitalizes on a subQ protocol.  The ester will actually be enanthate in this case, but that has a very similar profile to cypionate.  As of this writing, it had not been FDA approved, but they are already pushing for standard dosages:

“Testosterone enanthate administered subcutaneously once each week with possible titration to a higher or lower dose at scheduled intervals during study. Three dose strengths are available: 100 mg, 75 mg, and 50 mg.” [2]

2. Hypogonadal Males.  This Canadian study looked at subQ because “the intramuscular route, which is the most widely used form of testosterone replacement therapy, is inconvenient to many patients.” [6] Basically, the study concluded that it was a “no brainer” that got 100% of the males in the study within acceptable ranges.

3.  Fifth World Congress on the Aging Male Study.  The authors were clearly positive in a paper presented at this World Congress and concluded that “patients tolerated this therapy with no adverse effects…A once-week SC injection of 50-100 mg of TD appears to achieve sustainable and stable levels of phiologiccal T. This technique offers fewer physician visits and the use of smaller quantity of medication, thus lowering costs.” [7]

4. Drs. Crisler and Shippen.  There are two very well-known HRT physicians, Dr. Crisler and Shippen, that have been doing subQ testosterone cypionate injections for years with many of their patients. According to one of our senior posters, Dr. Shippen actually pioneered the technique:

“FYI…Dr Shippen was the one who pioneered the sub-q T injection method. When I was in his office, he told me that after I mentioned the Dr Crisler video demonstrating how to inject using that technique. He mentioned it modestly though…he’s a very humble guy and isn’t the kind of doctor who is into self-promotion.” [1]

Dr. Crisler must have jumped on board soon thereafter and became an apostle of the technique.  I know he has had actual training materials on his site for at least five years using this protocol.

5. Small Study on Hypogonadal and Transgender Men. One conference paper noted that two of the physicians had been using subQ injections with their transgender patients. Their protocol is very similar to the one that I see most often being utilized by men now: “T enanthate or cypionate was administered at a dose of 50-60 mg sc once weekly using 5/8″ 23g or 25g needles.” [3] The only difference is that most men use 27 or 29 gauge needles and are injecting 2-3 times per week for a total of about 100 mg of cypionate per week.  (I am currently injecting 40 mg twice a week for example.)

6. Transgender Men.  This study looked at  female-to-male individuals and was significant because it a) was fairly long term (6 months), recent (2014) and used the cypionate ester.  The authors noted that “subcutaneous delivery of testosterone for masculinization of transgender youth seems to be effective and well tolerated over short treatment times.” [4]

7. Peak Testosterone Poll.  For what it’s worth, 18% of the members doing standard HRT in a Peak Testosterone Forum Poll were using subQ cypionate injections.  That’s basically one out of five and clearly represents a significant percentage of those doing testosterone therapies.  Most doctors tend to feel more comfortable with the Big Pharma topicals and it should be noted that, as of this writing, there were as many men using subQ cypionate as all the topicals put together. [5]

CONCLUSION:  There are now multiple studies on hypogondal and transgender males with subcutaneous testosterone cypionate protocols as well as widespread clinical experience. SubQ has now been widely used for years and so interested doctors should be able to find meaningful data from which to pull from.

REFERENCES:

1)  https://www.peaktestosterone.com/forum/index.php?topic=3182.0

2) “A Recent Antares Pharma Patent Confirms The QuickShot Testosterone Product Will Debut Vibex Needle-Free Jet Injector Design And Novel Ethanol Formulation For Needle-Free Subcutaneous Injection”, https://seekingalpha.com/instablog/2421271-lokodude/3464615-a-recent-antares-pharma-patent-confirms-the-quickshot-testosterone-product-will-debut-vibex-needle-free-jet-injector-design-and-novel-ethanol-formulation-for-needle-free-subcutaneous-injection

3) San Francisco Endo 2013 Conference, Monday, June 17, 2013: 1:45 PM-3:45 PM, “Evaluation of the efficacy of subcutaneous administration of testosterone in female to male transexuals and hypogonadal males Program: Abstracts – Orals, Featured Poster Presentations, and Posters Session: MON 586-595-Reproductive Axis Determination, Development & Transgender Medicine, Basic/Clinical

4) LGBT Health, Sep 2014, 1(3): 165-167, “Subcutaneous Testosterone: An Effective Delivery Mechanism for Masculinizing Young Transgender Men”

5) https://www.peaktestosterone.com/forum/index.php?topic=4794.0

6) Saudi Med J, 2006 Dec, 27(12):1843-6, “Subcutaneous administration of testosterone. A pilot study report”

7) The Aging Male, March 2006, 9(1): 1 70, “Men s Health and Aging: The 5th World Congress on the Aging Male”, https://www.hormonebalance.org/ images/documents/ Lunenfeld%205th %20World%20Congress%20on%20the%20Aging%20Male%2006.pdf

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